Prevention of post‐operative nausea and vomiting in children – a prospective randomized double‐blind study

Sakellaris, George; Georgogianaki, P; Astyrakaki, Elissavet; Michalakis, M; Dede, Onur; Alegakis, Athanasios; Makatounaki, Katerina; Charissis, G.

doi:10.1111/j.1651-2227.2008.00804.x

Cited by 15 publications

(11 citation statements)

References 22 publications

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“…This value may be explained by the use of inhalational anesthesia, which traditionally has been associated with an increase in PONV (11). Acute postoperative pain increases the incidence of PONV (12). Is a quality indicator in the satisfaction surveys, and its incidence is difficult to quantify, but several authors agree that it is high.…”

Section: Discussionmentioning

confidence: 99%

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

et al. 2009

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Objectives: To assess the demographic characteristics and comorbidities of the group to be studied, as well as various quality indicators of a Major Ambulatory Surgery (MAS) program. Quantification of the surgical-anesthetic incidents. Study design: We aimed to perform a retrospective and descriptive analysis of disabled patients who had received oral ambulatory surgery under general anesthesia. Data obtained from the clinical history and telephone interview included the demographic characteristics, socioeconomic status, previous dental history, cause of the mental disability, degree of mental retardation, comorbidity measured according to the scale of the American Society of Anesthesiologists (ASA), anesthesia or preoperative surgical treatments, level of analgesia, length of stay, incidents in the Resuscitation Ward, the rate of substitution, suspensions, patients admitted, complications and the degree of patient satisfaction. Results: We included 112 oral surgery procedures performed on disabled patients who were treated under general inhalational anesthesia as part of MAS during the years 2006-2007. During this period, 577 restorations, 413 extractions, 179 sealants, 102 pulpectomies, 22 root canal treatments, 17 gingivectomies and 3 frenectomies were performed. A total of 75% (78 cases) of the patients had coexisting medical pathology. The average surgery time per patient was 72.69 ±29.78 minutes. The rate of replacement was 100%. The rate of suspension was 1.92%. The percentage of patients readmitted was 1.92%,due to significant bleeding in the mouth, which did not require treatment and the patients were discharged from hospital 24 hours after being admitted. The rate of patients who required re-hospitalization was 3.84%. Conclusions: The MAS performed in this group, despite being on patients with high comorbidity resulted in only a low number of medical incidents reported.

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Section: Discussionmentioning

confidence: 99%

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

et al. 2009

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“…Both inadequate postoperative pain control and emesis activate the sympathetic nervous system and increase the intracranial pressure, and the postoperative care for pain and emesis can be very closely related to their morbidity and mortality of pediatric moyamoya patients [2,3]. Continuous intravenous infusion with fentanyl [4] was suggested to be effective for postoperative pain control in pediatric patients, but fentanyl also acts as a risk factor for postoperative nausea and vomiting (PONV) [5,6]. For high risk PONV patients, a multimodal approach is recommended [7] because most antiemetics work independently of each other and of the patient's risk factor [8].…”

Section: Introductionmentioning

confidence: 99%

Small dose of propofol combined with dexamethasone for postoperative vomiting in pediatric Moyamoya disease patients: a prospective, observer-blinded, randomized controlled study

Kim

Jang

Kim

et al. 2013

Korean J Anesthesiol

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BackgroundFor effective postoperative antiemetic management in pediatric moyamoya disease patients receiving fentanyl based postoperative analgesia, a multimodal approach has been recommended. The uncertain efficacy of ondansetron for pediatric neurosurgical patients or the possible antiemetic effect of small dose of propofol motivated us to evaluate the preventive effect of a subhypnotic dose of propofol combined with dexamethasone on postoperative vomiting (POV), especially during immediate postoperative periods.MethodsIn a prospective observer-blind randomized controlled study, we compared dexamethasone 0.15 mg/kg alone (Group D) with dexamethasone combined with propofol of 0.5 mg/kg (Group DP) in 60 pediatric patients, aged 4-17 years, who underwent indirect bypass surgery and received fentanyl-based postoperative analgesia. Occurrence of vomiting and pain score (Wong-Baker facial score) and requirement of rescue analgesic and antiemetic were continually measured (0-2, 2-6, 6-12 and 12-24 postoperative hours). For statistical analysis, in addition to the Fisher's exact test, a generalized linear mixed model (GLMM) and the linear mixed model (LMM) for repeated measures were used for vomiting and pain scores, respectively.ResultsThere was no statistical significance of POV incidence, requirement of rescue analgesic and pain score between the two groups at any measured intervals. The incidence of POV was 53.3% during 24 hours in both groups, and was especially 6.7% and 13.3% (P = 0.671) during 0-2 hr and 16.7% and 23.3% (P = 0.748) during 2-6 hr in group D and group DP, respectively.ConclusionsA small dose of propofol combined with dexamethasone appears ineffective to preventing POV in pediatric moyamoya patients receiving continuous fentanyl infusion.

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“…[22][23][24][25][26][27][28][29] Other studies reported efficacy of the drug in pediatric surgical or oncology patients. [30][31][32][33][34][35][36][37][38][39] One of those studies reported mild, asymptomatic QT prolongations that remained within normal limits. 31 A literature search was performed for reports of ventricular arrhythmias, fatalities, or any type of toxicity thought to be related to ondansetron in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Fatal Cardiac Arrest in 2 Children

Brenner¹,

Boucher²

2016

Pediatr Emer Care

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Prevention of post‐operative nausea and vomiting in children – a prospective randomized double‐blind study

Abstract: We found that the use of ondansetron did not change the incidence of PONV, the avoidance of opioids and the adequate analgesia may contribute to this. Post-operative oral intake of liquid, (within the first 4 h), increases the risk for PONV.

Cited by 15 publications

References 22 publications

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

Small dose of propofol combined with dexamethasone for postoperative vomiting in pediatric Moyamoya disease patients: a prospective, observer-blinded, randomized controlled study

Fatal Cardiac Arrest in 2 Children

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